37239 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 37239

4 of 4 payer prior-auth lists that name 37239 require prior authorization or set conditions: Cigna.

PayerPlanStatePrior authConditionsSinceSource
CignaACA/IFPAllprior auth requiredMay be delegated to eviCore for some clientsAug 23, 2019Master Precertification List (For Health Care Providers)
CignaComplete/PHS+/PreferredAllprior auth requiredMay be delegated to eviCore for some clientsAug 23, 2019Master Precertification List (For Health Care Providers)
CignaVascular InterventionsAllprior auth under conditionsAdd-on code: requested with the primary procedureMar 7, 2026Cigna Vascular Interventions Commercial Code List (title from file name)
CignaVascular InterventionsAllprior auth under conditionsAdd-on code: requested with the primary procedureMar 7, 2026Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs

Payer coverage policies that name 37239

37239 appears in 13 coverage policies from Aetna, Anthem, Regence.

PayerPolicyRole in policyReviewedDocument
AetnaAnesthetic and Antiemetic Infusion Pumps (0607)listed, no stance (range 33016-37799)Sep 9, 2026payer document
AetnaBalloon-Expandable Venous Stents (0531)covered if criteria are metAug 27, 2026payer document
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 33010-37799)Jul 30, 2026payer document
AetnaCardiovascular Ultrafiltration (0741)listed, no stance (range 33010-37790)Oct 30, 2025payer document
AetnaDrug-Eluting Stents (0621)listed, no stance (range 37238-37239)Sep 23, 2026payer document
AetnaEndovascular Arterial and Venous Stent Procedures (0785)covered if criteria are metJun 5, 2026payer document
AetnaIntravascular Ultrasound (0382)listed, no stanceMay 26, 2026payer document
AetnaNegative Pressure Wound Therapy (0334)listed, no stance (range 33016-37799)Jun 8, 2026payer document
AetnaNitric Oxide, Inhalational (INO) (0518)not covered (range 33016-37790)Jul 2, 2026payer document
AetnaPeripheral Atherectomy and Thrombectomy Devices (0295)covered if criteria are met (range 37220-37247)Apr 16, 2026payer document
AetnaStereolithographic Models and Implants (0613)listed, no stance (range 33010-37790)Sep 3, 2026payer document
AnthemVenous Angioplasty with or without Stent Placement or Venous Stenting Alone (CG-SURG-106)covered if criteria are metFeb 19, 2026payer document
RegencePercutaneous Angioplasty and Stenting of Veins (Surgery 109)listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

  • AZ: $1500.32 (outpatient_hospital, RF133), effective Oct 1, 2025
  • CO: $201.99 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $102.35 (physician, facility), effective Jan 1, 2026
  • IL: $207.78 (practitioner), effective Apr 1, 2024
  • IN: $111.21 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $1502.42 (asc, facility), effective Jan 1, 2014
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $1326.57 (professional), effective Jan 1, 2014
  • MA: $0.00 (asc), effective May 1, 2026
  • MS: $111.93 (comprehensive), effective Jul 1, 2026
  • ND: $1852.68 (physician), effective Aug 1, 2026
  • NE: $889.20 (physician, non-facility), effective Jul 1, 2026
  • NY: $89.02 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $119.39 (physician, facility), effective Jan 1, 2014
  • OK: $117.60 (physician, facility), effective Jul 1, 2026
  • TX: $110.58 (physician, Physician, facility), effective Sep 1, 2026
  • VA: $114.00 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $75.10 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.